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NPI Code Detail

MEDICARE: RHIANNON ALLEN OTR/L

MEDICARE: RHIANNON ALLEN OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist0119005251VA
2225X00000XOccupational TherapistOT13457FL

General Provider Information

NPI Number : 1265735351
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHIANNON ALLEN OTR/L
Provider Business Mailing Address
First Line : 917 OTTER CREEK DR
Second Line :
City : ORANGE PARK
State : FL
Zip : 32065-2507
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1604 OLD DONATION PKWY
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-3063
Country : US
Telephone Number : 904-557-3210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2010
Last Update Date : 12/10/2010

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